6 курс / Гастроэнтерология / Аутоиммунные_заболевания_печени_в_практике_клинициста_Ивашкин_В

72

h 3. ? " '- " "!,* > %

# # . " + ' $ " + ($ + '-" +" " + !* ! !' +"- % )-> ?`_. ? - "!+-> ( " , % '$ -=-)-> + " + ( + + ! ?`_ $-90–97%, 5- $$ – 85–88% [Narumi S. et al., 1995; Goss J.A. et al., 1997]. ` = , -= ' " + ) !-

, !' " + > % "(- ( 10% " -

+ ( ). ' +$ " + ( , +" , " " $ " + " % ( "" , >$ " ) % +"$% > + " ( - +" $= "!-;! ( + ' . _! +" % ( " = ' + % )$ ' , +" !,- * )- + " ($ +- - !" "-[Neuberger J. et al., 1999].

- =$ + " + ( % + " ! )-> ?`_:

•" >" ' ! + ' "= " - + , ' +"$* % + " ;

•) "- " !"-;

•$ ) " % ;

•" ) + ' ' " " ;

•; +" ; "- )$.

p " ( ?`_ % 20%, >$, +-!, "- (- -, % $ $ -= + (-" + . b )-> ' ?`_ <o9 " + ($ + ' $ ' <o9, ' " " % ( .

3.8. 1 " ($ -

`" = ?`_ = - !,* : - =$ > ( "" , = + ( ; ' .

. =$ > +" ?`_ +" ' - % '- - +" ? d ( . ". 50), " ( + > '-

74

h 3. ? " '- " "!,* > %

9 ' '- + ; " "!, $ !

15–20% )->. p * % )" !, $ $ $ +"-

% % + ' ' % +" , %! = + " = )- * + ' '- = '- +" . ` " !"- )-' - ; "!, &+ ) " % > % : +$ ! = !> , ! , > " , ) , +" + " ) " .

) "!= " !"- ! )> -+-$ ( % ' % $ $ ,'$ > % "- (-. !' )" ' +" "- " !"- +"-

$, - '$, )$ ($, !

) "-> " "!- + " ( = '->

+" > [Eckhauser F.E. et al., 1996]. " >$ -

$ , ' + " ' " !" +

( "" ' > $> )$ - +-

" ( " )-> ( "" . ? = -

+" + ' $ & + ' " + ' '

!" . ? - D.H. Van Thiel . (1995), ! ) "- % ! !' ' ) > ' + ,! 57% )-> )! $ " !" + '-" 29 .

f ' ( b +"$ ) "-

- +" + " " % + " $. K.N. Lazaridis

(1999) !- - !, &;; ( +" ; ( . % "- " !, + !+ "$ " ;- ( !" !, ) +" ; ! ( , +" " *-$ " ( , " !- " "!-> + ( &;; ! !, .

g – = ! 5–20% )-> ?`_, "-

,* $, +" , ( "" ' )

[Broome U., Bergquist A., 2000]. < " + !, > % "(- ! " " + -$ $, ! 10% + ( , "- )--+ " + ($ + ' + + ! ?`_. # "$ > % "(- ( " " , + ; "-

3.9. 9( ( " &

?`_, +" , > " " ! $ >" ' +" %" - "!,* ' . ? - ) "!+ % $, ,' % 174 + ( , "$$ +" =-= +" ?`_ $ 11,9 % [Wiesner R.H. et al.,

78

h 3. ? " '- " "!,* > %

' #

Aadland E., Schrumpf E., Fausa O. et al. Primary sclerosing cholangitis: a long-term follow-up study // Scand. J. Gastroenterol. – 1987. – Vol.22. – P.655–664.

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80

h 4. 9 ) "- + " " - ! !- "-

, > ' !* $ $ + )* +" $ )-> ? d.

d d % / !* > " " ! $" ) > ) ) , $ ! 9% )- * % ' )-> ? d. b ) % - ? d % + " " % " ! , +" ' 24 !,* > " " [Chazouielleres O., 1998, 2000]:

•f 5 " ;

•IgG 2 " ;

•SMA % ' " ;

•+ " + "- !+ '- "-.

$ '$ ( ($ " h/? d HLA B8, DR3 DR4. -" +"$, $ " )"- !- , +" & ) + ' ) ($ , ANA SMA.

p -$ $ ! )-> h, + "- -,$ 25%, > " )-' % % - ' % '$. 9" % , +" h, +" , )- , + ( ; ' , $ ? d, >$ 8% !' ) ,- $ -" ) + '-> % ! ! " )"-- > " 2. ` ! = = =- + % " ! +" +"$ !-

; , " ( ( ! > ; , " ( "-

-LKM-1.

h % ' -$ $, !+ '- "- '

+ " ! !$" ; " ( + "-> " "!-

"" "! -" = , +-" ' > -+ " >- + ' . b % > )-> -, $ &;- ;- " "-, ' +$ +" $ - % " +" ) ' - +"$ '$ h " 3–6 . O. Chazouilleres (1998) !--- !, &;; ) ( +" b0_9, +" " +" = , + "-! ) + ( .